Description: The lack of suitable biomarkers for personalized treatment protocols and delineating field cancerization prevents further progress in clinical outcomes. In the light of this perspective, MicroRNAs could be promising biomarkers both in terms of diagnostic and prognostic value. The aim of this prospective study is to find strong prognostic microRNA biomarkers for advanced laryngeal carcinoma and molecular signatures of field cancerization. Sixty patients were enrolled and four samples were collected from each patient: tumor surface and depth, peritumor normal mucosa, and control distant laryngeal mucosa. Initially, a global microRNA profile was conducted in twelve patients from the whole cohort and subsequently, we validated a selected group of 12 microRNAs with RT-qPCR. The follow-up period was 24 months (SD ± 13 months). Microarray expression profile revealed 59 dysregulated microRNAs. The validated expression levels of miR-93-5p (χ2(2) = 4.68, log-rank p = 0.03), miR-144-3p (χ2(2) = 4.53, log-rank p =.03) and miR-210-3p (χ2(2) = 4.53, log-rank p = 0.03) in tumor samples exhibited strong association with recurrence-free survival as higher expression levels of these genes predict worse outcome. Tumor suppressor genes miR-144-3p (mean rank 1.58 vs 2.14 vs 2.29, p=0.000) and miR-145-5p (mean rank 1.57 vs 2.15 vs 2.28, p=0.000) were significantly dysregulated in peritumor mucosa with a pattern of expression consistent with paired tumor samples thus revealing a signature of field cancerization in laryngeal carcinoma. Additionally, miR-1260b, miR-21-3p, miR-31-3p and miR-31-5p were strongly associated with tumor grade. Our study reports the first global microRNA profile specifically in advanced laryngeal carcinoma that includes survival analysis and investigates the molecular signature of field cancerization. We report two strong biomarkers of field cancerization and three predictors for recurrence in advance stage laryngeal cancer.

Published: https://www.nature.com/articles/s41598-022-20338-w

Outcome Objectives: To demonstrate the possibilities of microRNA molecules as biomarkers and broaden the understanging of field cancerization among head and neck surgeons.

1. Popov et al. Global microRNA expression profile in laryngeal carcinoma unveils new prognostic biomarkers and novel insights into field cancerization. Sci Rep. 2022 Oct 12;12(1):17051. doi: 10.1038/s41598-022-20338-w. [IF 4.9, Q1]

1. Kyurkchiyan SG…Popov TM. Peritumor Mucosa in Advanced Laryngeal Carcinoma Exhibits an Aberrant Proangiogenic Signature Distinctive from the Expression Pattern in Adjacent Tumor Tissue. Cells. 2024 Apr 5;13(7):633. doi: 10.3390/cells13070633. [IF 6.0, Q1]

2. Kyurkchiyan S, P….Popov TM. Co-expression of miRNA players in advanced laryngeal carcinoma - Insights into the roles of miR-93-5p, miR-145-5p, and miR-210-3p. Biomol Biomed. 2024 Sep 23. doi: 10.17305/bb.2024.10947. Epub ahead of print. PMID: 39412136. [IF 3.1, Q2]

3. Komitova K…; Popov, T.M. A Critical Review on microRNAs as Prognostic Biomarkers in Laryngeal Carcinoma. Int. J. Mol. Sci. 2024, 25, 13468. https://doi.org/10.3390/ijms252413468 [IF 4.9, Q1]

4. Popov TM, et al. Proangiogenic signature in advanced laryngeal carcinoma after microRNA expression profiling. Mol Biol Rep. 2020 Jul;47(7):5651-5655. doi: 10.1007/s11033-020-05250-8. Epub 2020 Jun 12. PMID: 32533400. [IF 2.6, Q2]

Histology based multimodal treatment concepts of sinonasal malignancies

Nasal and sinus masses in children

Description This round table is submitted by the European Pediatric Skullbase taskforce from ESPO. It will explore one of the most critical challenges in managing juvenile nasopharyngeal angiofibroma (JNA): residual disease. Despite advances in endoscopic resection and embolization, complete tumor removal remains complex, particularly in cases with skull base or intracranial extension. The session will focus on how optimal planning of the initial surgery—through imaging, staging, and multidisciplinary collaboration—can reduce residual risk. It will also examine the nuances of postoperative management: Should all residual tumors be reoperated? When is imaging surveillance appropriate? Are there non-surgical alternatives for indolent residual disease? Faculty will share decision-making algorithms, long-term outcomes, and illustrative cases to help define modern standards of care.

Outcome Objectives By the end of the session, participants will be able to:

1. Optimize the planning of initial JNA surgery to minimize residual disease.

2. Identify radiologic and intraoperative predictors of incomplete resection.

3. Differentiate between residual and recurrent disease using imaging and clinical criteria.

4. Evaluate the risks and benefits of reoperation versus surveillance.

5. Understand current and emerging alternatives to surgical reintervention for residual JNA.

Background Residual disease in JNA remains a source of clinical uncertainty, especially when the remnant is small, asymptomatic, or surgically risky. Incomplete resection may stem from intraoperative bleeding, complex tumor extensions, or the need to avoid critical neurovascular structures. Not all residual lesions behave aggressively; some remain stable for years. This symposium will provide a critical overview of strategies to reduce residual disease risk from the outset and explore evidence-based approaches to managing remnants. The discussion will help clinicians move beyond a binary “operate or not” framework toward a personalized, risk-adapted model of care.

Management of Orbital, Skull Base and Maxilla Involvement in Sinonasal Malignancies